This community-based participatory research (CBPR) project by the Aberdeen Area Tribal Chairmen's Health Board and University of Iowa concerns American Indian children and a chronic disease that affects them disproportionately-early childhood caries (tooth decay). In tribal communities 79 percent of children have caries by first grade, compared to only 24 percent for all races. A large proportion of tribal children have an aggressive and destructive form of the disease called rampant early childhood caries (ECC). Rampant ECC causes a child pain, difficulty in eating, and speech delay. Despite implementation of caries-control measures found effective in other populations, the rate of ECC actually increased in tribal communities from 1991-1999. This research will use a CBPR model to combine existing and emerging anti-caries technologies, new behavioral intervention strategies, and new service delivery paradigms to reduce the health disparity from ECC in American Indian children. The wisdom and experience of the participating communities will guide the efforts of the investigators and consultants in all phases of this research. The long-term goal for this current three-year research cycle is to develop, test, and evaluate innovative, evidence based models to prevent ECC in Northern Plains tribal communities. The specific aims include the following: (1) Recruit three tribal communities to participate in the development and implementation of community-based research designed to improve the oral health of their children; (2) Assess the social, structural, and environmental strengths and barriers related to improving the oral health status of the children of the community; (3) Develop, implement, and pilot test evidence-based research projects to improve the oral health status of children that are both scientifically sound and fully endorsed by the community; (4) Evaluate the effectiveness of the interventions in terms of both process measures and short-term outcomes; and (5) Perform a qualitative assessment of the CBPR process and its impact on the infrastructure needed to improve the oral health of young children. This research will greatly expand the knowledge base for effective early childhood caries prevention in high prevalence communities throughout the country. [unreadable] [unreadable]